Severity of leukoaraiosis determines clinical phenotype after brain infarction
| Autor: | Jonathan Rosand, A. G. Sorensen, Mark Vangel, Hakan Ay, Natalia S. Rost, K. L. Furie, A. Bayrlee, Ethem Murat Arsava |
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| Rok vydání: | 2011 |
| Předmět: |
Brain Infarction
Male medicine.medical_specialty Infarction Severity of Illness Index Central nervous system disease White matter Interquartile range Internal medicine Severity of illness Image Processing Computer-Assisted medicine Humans cardiovascular diseases Aged Retrospective Studies medicine.diagnostic_test Cerebral infarction business.industry Leukoaraiosis Magnetic resonance imaging Articles Middle Aged Prognosis medicine.disease Magnetic Resonance Imaging Surgery Diffusion Tensor Imaging Phenotype medicine.anatomical_structure Disease Progression Cardiology Female Neurology (clinical) business |
| Zdroj: | Neurology. 77:55-61 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0b013e318221ad02 |
| Popis: | To determine whether the extent of leukoaraiosis, a composite marker of baseline brain integrity, differed between patients with TIA with diffusion-weighted imaging (DWI) evidence of infarction (transient symptoms with infarction [TSI]) and patients with ischemic stroke.Leukoaraiosis volume on MRI was quantified in a consecutive series of 153 TSI and 354 ischemic stroke patients with comparable infarct volumes on DWI. We explored the relationship between leukoaraiosis volume and clinical phenotype (TIA or ischemic stroke) using a logistic regression model.Patients with TSI tended to be younger (median age 66 vs 69 years, p = 0.062) and had smaller median normalized leukoaraiosis volume (1.2 mL, interquartile range [IQR] 0.2-4.7 mL vs 3.5 mL, IQR 1.2-8.6 mL, p0.001). In multivariable analysis controlling for age, stroke risk factors, etiologic stroke mechanism, infarct volume, and infarct location, increasing leukoaraiosis volume remained associated with ischemic stroke (odds ratio 1.05 per mL, 95%confidence interval 1.02-1.09, p = 0.004), along with infarct volume and infarct location.The probability of ischemic stroke rather than TSI increases with increasing leukoaraiosis volume, independent of infarct size and location. Our findings support the concept that the integrity of white matter tracts connecting different parts of the brain could contribute to whether or not patients develop TSI or ischemic stroke in an event of brain infarction. |
| Databáze: | OpenAIRE |
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